Cutting-Edge Therapies Offer New Hope

This article appeared in the 2023 Silver Hill Hospital Annual Report. It was written by Chris Bozak, Silver Hill Hospital Advancement Content Manager.

While tried-and-true methods are a mainstay in psychiatry and at Silver Hill, we are always looking for new, innovative, evidence-based therapies to add to our treatment toolbox.

With ketamine treatment coming soon and electroconvulsive therapy (ECT) already reinstated at Silver Hill, we are excited to be expanding our Interventional Psychiatry Services (IPS). We also plan to add transcranial magnetic stimulation (TMS) and to offer psychedelics such as psilocybin and MDMA, in research protocols and more widely once they are approved, to further extend these innovative and cutting-edge therapies.

“Adding an interventional service, which is at the forefront of psychiatry, is an exciting next step for Silver Hill and will allow the hospital to provide additional highly effective treatments for patients,” says William Prueitt, MD, who will lead Silver Hill’s ketamine program. “The service also has an eye to the future and the potential incorporation of other interventional treatments.”

Interventional psychiatry is an emerging subspecialty of psychiatry that utilizes novel pharmacology and brain stimulation techniques to modify dysfunctional brain circuitry. IPS treatments, both the well-established and emerging, have been proven to enhance outcomes for patients with persistent, treatment-resistant disorders, when used in conjunction with psychotherapy.

With experienced physicians leading the program, and in partnership with Yale School of Medicine and Yale New Haven Hospital, Silver Hill will establish the region’s top IPS. All interventional services will be administered by our highly trained clinicians and paired with psychotherapy.

Silver Hill recently reinstated ECT after pausing the treatment during COVID. Anri Kissilenko, MD, leads Silver Hill’s ECT program. ECT creates a brief electrical stimulation of the brain while the patient is under anesthesia. ECT is often misunderstood because of the way it was used in the past and how it has been depicted in movies. Today’s ECT is safer, more controlled and can provide quick and significant improvement in people with severe depression, mania, and other disorders.

Similarly, TMS uses magnetic fields to stimulate nerve cells in the brain. Silver Hill hopes to add TMS to its IPS offerings soon.

Later this year, Silver Hill will begin offering ketamine treatments for patients with depression and other disorders. Ketamine is a dissociative drug used for treating depression and other mental health disorders. It has long been used as an anesthetic and has only recently been recognized for its therapeutic value in mental health. The FDA approved in 2019 a version of ketamine, called esketamine, as a medication for treatment-resistant depression.

“This medication has novel targets in the brain, is dosed intermittently, supports neuroplasticity, is rapid acting, and can even decrease suicidal thinking,” Prueitt says. “As John Krystal, the Chair of Psychiatry at Yale and leading ketamine expert, put it so succinctly, ‘this is a game changer.’”

Prueitt came to Silver Hill from Yale School of Medicine where he gained extensive experience working with patients being treated with ketamine. Yale has one of the biggest ketamine programs in the country.

In addition to rapid and short-term benefits, ketamine also “appears to facilitate the creation of new neural pathways that can help them develop resiliency and protect against the return of the depression,” says Gerard Sanacora, PhD, MD, Professor of Psychiatry, Director of Yale Depression Research Program, and Co-Director of Yale New Haven Hospital Interventional Psychiatry Service.

Yale Medicine has been at the forefront of studying the use of psychedelics in the treatment of mental health disorders. There is growing evidence that ketamine and psychedelics have both short- and long-term benefits in treating depression, anxiety, OCD and other mental health disorders when administered and supervised properly. Silver Hill and Yale have a long history of working collaboratively and using expertise from both organizations to offer innovative programs and treatments to patients.

Silver Hill Hospital constantly strives to improve outcomes for all patients. Interventional services, paired with traditional treatments and therapies, is another example of Silver Hill remaining at the forefront of psychiatry.